Smad1、Smad5在肾阳虚不育大鼠睾丸中表达的研究

目的: 观察Smad1、Smad5在腺嘌呤诱导的肾阳虚不育大鼠睾丸中的表达,探讨肾阳虚不育的病理机制,为防治男性不育提供可靠的实验依据。　方法: 60d雄性SD大鼠 48只,随机分为 6组(肾阳虚 7、14、21d组;正常对照7、14、21d组),每组 8只。以腺嘌呤 300mg/kg给大鼠灌胃,诱导肾阳虚不育大鼠模型,于灌胃第 7、14、21d,用免疫组化SABC法测定Smad1、Smad5在其睾丸中的表达。　结果: Smad1表达见于所有正常对照组及模型组大鼠睾丸各级生精细胞的胞质内,支持细胞及间质细胞未见表达;灌胃第 7、14d与正常对照组相比差异无显著性(P>0. 05),第 21d的表达较正常对照组及第 7、14d明显减弱(P<0. 05)。Smad5表达见于正常对照组及腺嘌呤灌胃第 7d大鼠睾丸的初级精母细胞及精原细胞的胞核内,两组比较差异无显著性(P>0. 05),其余各级生精细胞、支持细胞及间质细胞均未见表达;灌胃第 14、21d大鼠睾丸中未见Smad5表达。　结论: 肾阳虚大鼠睾丸中Smad1表达的减弱及Smad5的无表达,可能是导致其不育的病理机制之一。     

Stat3与过氧化物酶体增殖因子激活受体δ信号转导通路间交互作用对结肠癌细胞增殖的调控影响

目的观察选择性环氧合酶（COX）-2抑制剂NS-398对结肠癌细胞系SW480中Star3与过氧化物酶体增殖因子激活受体（PPAR）δ信号转导通路的影响，探讨不同信号转导通路间交互作用调控结肠癌细胞增殖的分子机制。方法应用逆转录．聚合酶链式反应（RT-PCR）法检测结肠癌细胞系SW480中COX-2 mRNA表达水平，用选择性COX-2抑制剂NS-398处理结肠癌细胞系SW480，Western blot检测Star3与PPARδ信号转导通路成员表达，噻唑蓝（MTT）比色试验检测细胞增殖状态，流式细胞技术检测细胞周期与凋亡。结果结肠癌细胞系SW480中未检测到COX-2 mRNA表达，NS-398（75μmol／L）作用于SW480细胞72h后，G1期细胞比率由37．9％上升至48．6％，S期细胞比率分别由58，1％，下降至44．9％，细胞增殖受抑制。Stat3、PPARδ、Cyclin D1与bcl-x L表达水平随NS-398作用时间延长而下降。结论选择性COX-2抑制剂NS-398可能通过非COX-2依赖途径影响结肠癌细胞的增殖。     

颈脊髓后方致压三维运动下生物力学分析

目的研究颈黄韧带病变对颈脊髓后方致压,颈脊髓所受压力与致压深度、颈脊柱三维运动的关系,为探讨黄韧带病变所致颈脊髓病的发病机制提供运动学、生物力学依据。方法采用5具新鲜成人尸体颈脊柱标本(C2～C7)通过后方C4～5间骨窗伸入直径9．58 mm的半球形致压物模拟颈椎黄韧带病变时对颈脊髓后方所形成的压迫。实验对颈脊髓由后向前致压,致压深度分别为椎管中矢径的10％～60％、依次增加10％。分别测量各运动位置,不同致压深度下,颈脊膜脊髓后方所受压力。结果 (1)随致压深度的增加颈脊髓脊膜后方所受压力明显加大,两者呈非线性关系。(2)颈脊髓后方致压时,测得颈脊髓脊膜后方所受压力,在前屈后伸运动中,20％～60％各相邻致压深度两两比较,差异有统计学意义(P<0．05);在中立位、左右侧弯、左右旋转运动中运动中 30％～60％各相邻致压深度两两比较,差异有统计学意义(P<0．05);(3)左右侧弯、左右旋转时, 相同致压深度,两侧侧弯、旋转各自比较差异无统计学意义(P>0．05)。予以合并取均数分别命名为侧弯30°位、旋转15°位。(4)在各运动位置,不同致压深度颈脊髓脊膜后方所受压力变化比较, 30％～60％致压深度时,前屈30°位>侧弯30°位>后伸30°位>中立位>旋转15°位。10％～20％致压深度时,侧弯30°位>后伸30°位>前屈30°中立位>旋转15°位。结论颈脊髓后方所受压力与致压深度和颈脊柱运动有着密切联系。所受压力随致压深度增加而增大,深度超出30％临界值后有统计学意义。相同致压深度颈脊髓后方所受压力大小随运动方向不同而改变,前屈后伸运动对颈脊髓的压力影响最大。     

高纯度透析浓缩液对血液透析患者血清白细胞介素6、肿瘤坏死因子α和白蛋白水平的影响

目的比较高纯度透析浓缩液和普通透析浓缩液对长期透析患者血清促炎症因子白细胞介素(6IL鄄6)、肿瘤坏死因子α(TNF鄄α)和血清白蛋白的影响。方法采用前瞻性临床对照研究,将85例维持性血液透析患者随机分为两组,分别采用普通透析浓缩液(常规组,例)和42高纯度透析浓缩液(高纯度组,例)进行常规低通量血液透析治疗并随访4312个。月比较常规组与高纯度组患者在血清IL鄄6、TNF鄄α、血清白蛋白、干体重、体重指数(BMI)、上臂中肌肉周径(MAC)、血红蛋白、红细胞压积、白细胞计数、中性粒细胞计数以及红细胞生成素应用剂量上的差异。结果高纯度组43例,常规组42例,两组患者间年龄、性别比例、透析龄、BMI、Kt/V值和血清IL鄄6、TNF鄄α水平差异无统计学意义。与基础水平比较,随访结束时高纯度组患者血清IL鄄6[(6.91±5.13)pg/ml比(3.06±2.42)pg/ml]和TNF鄄α水平[(14.78±4.61)pg/ml比(13.60±4.24)pg/ml]显著下降;血清白蛋白[(35.9±3.7)g/L比(37.6±3.4)g/L]、血红蛋白[(82.4±24.7)g/L比(88.2±22.9)g/L]及红细胞压积(0.25±0.07比0.28±0.05)均显著上升。与常规组比较,随访结束时高纯度组血清IL鄄6[(3.06±2.42)pg/ml比(4.22±3.99)pg/ml]和TNF鄄α水平[(13.60±4.24)pg/ml比(15.79±6.38)pg/ml均显著下降     

RASSF1A在胰腺癌组织中的表达及其临床意义

目的 探讨押癌基因RASSF1A在胰腺癌组织中的表达及其与胰腺癌发生、发展的关系.方法 采用逆转录-聚合酶链反应(RT-PCR)方法检测48例胰腺癌组织及癌旁正常组织RASSFA mRNA的表达水平.结果 癌旁正常组织RASSF1A mRNA的表达量高于高分化腺癌组织RASSF1A的表达量,差异有统计学意义(P<0.05).高分化腺癌组织RASSF1A mRNA的表达量高于中低分化腺癌组织,差异有统计学意义(P<0.01).TNM分期Ⅲ期RASSF1A mRNA的表达量低于Ⅰ、Ⅱ期,差异有统计学意义(P<0.05).RASSF1A mRNA表达与性别、年龄,肿瘤发生部位无明显关系(P>0.05).结论 RASSF1A表达缺失或低下在胰腺癌的发生、发展中起重要的作用.     

Meta分析法在我国护理科研中的应用现状

目的 了解我国护理科研中Meta分析法的应用现状.方法 通过计算机检索中国学术期刊全文数据库1999年1月至2008年5月<中华护理杂志>、<护理学杂志>、<护理研究>等9种中国科技论文统计源期刊上刊登的有关Meta分析法的文章以分析其应用现状.结果 检索到16篇相关文献,介绍Meta分析3篇,专科护理实践8篇(其中2篇文章为同一作者),护理教育1篇,基础护理研究4篇.结论 Meta分析在护理科研中的应用处于初级阶段,许多护理领域Meta分析的应用仍是空白.护理工作者应该不断学习,提高自身素质和科研水平,应用Meta分析方法来汇总同类研究的不同研究结果,提高学科科研水平.     

1例冠脉造影并发左冠状动脉痉挛急性闭塞患者的急救护理

对1例冠状动脉造影并发左冠状动脉痉挛急性闭塞的患者进行紧急心肺复苏,植入临时起搏器,复苏初步成功后,转入CCU行进一步脑复苏及生命支持等治疗措施．同时密切观察病情．重视休息、饮食指导及心理疏导等。结果患者转危为安,病情稳定后行冠状动脉搭桥术后痊愈出院。     

HIZ与椎间盘造影在椎间盘源性腰痛诊断中的对比研究

目的对比MRI T2WI上HIZ（high intensity zone）与椎间盘造影对椎间盘源性腰痛的诊断价值。方法2006年9～2007年12月,对43例严重下腰痛患者进行MRI检查以及椎间盘造影术,对MRI T2WI存在HIZ表现的患者以及椎间盘造影阳性的患者进行回顾性分析。结果43例患者中,26例患者的31个节段有HIZ表现（60．5％,26／43）,其中17例造影阳性,阳性率为65．4％（17／26）;17例无HIZ表现的患者中4例造影阳性,阳性率为（23．5％,4／17）。43例患者中,共计21例患者23个节段造影阳性,阳性率为48．8％（21／43）。结论慢性下腰痛患者中HIZ对椎间盘源性腰痛有较高的提示作用,但确诊仍需椎间盘造影术予以明确。     

Combined anterior and posterior surgery for treatment of cervical fracture-dislocation in patients with ankylosing spondylitis

To discuss the pathological characteristics of cervical spinal fracture complicating ankylosing spondyli-tis-(AS) and the effect of combined anterior and posterior operation. Methods: Eighteen AS patients with traumatic cervical fracture-dislocation were treated operatively from January 2000 to January 2006. The symptom duration of AS was 14.5 years on average. Three cases had undergone osteotomy in lumbar spine. There were 4 cases of Grade A, 3 cases of Grade B, 9 cases of Grade C and 2 cases of Grade D accord-ing to Frankel's score. There were 15 cases of Grade Ⅲ dislocation and 3 cases of Grade Ⅱ. All patients underwent surgical procedures by combined anterior and posterior approach.Results: There were 4 anterior-posterior procedures, 8 anterior-posterior-anterior procedures and 6 posterior-an-terior procedures. Seven patients had one stage operation and 11 cases underwent two stage surgeries. There was certain extent of neorological improvement in 14 incomplete paraplegic patients, but no improvement in 4 complete paraplegic patients. The follow-up period was 21.2 months on average and the time for bone fusion was 3.6 months. There were 4 complications during operation and a long-term complication in follow-up. Conclusions: The study suggests that anterior com-bined with posterior approach makes the spine stable and relieves the pressure immediately. It is a reasonable surgical strategy for treatment of cervical spinal fracture-dislocation with AS.     

多房性囊性肾癌一例报告及文献复习

Objective To discuss the diagnosis and outcome of multilocular cystic renal cell car-cinoma. Methods The clinic data of 1 case of multilocular cystic renal cell carcinoma were reviewed with its clinical manifestation, imaging, pathology and therapy in our hospital. The male patient aged 49 was incidentally found to have a right renal tumor. The CT scan showed a multiloeular cystic tumor in the low pole of the right kidney with a clear outline. The thin septa were found in the tumor, which were enhanced in the enhancement CT scan. The enhancement MRI showed the cystic wall was en-hanced. Results The patient received a partial nephrectomy as his treatment. The pathological char-acteristics were as following: the multilocular cystic tumor was about 3 cm×2 cm×2 cm with clear serosity in it. The cystic wall was smooth with the width of 0.1-0.2 cm. Most of the cystic cavities were covered by monostratified or stratified cubic clear cells, and some were covered by squamous epi-thelium or no epithelium at all. The septum was composed of collagen fiber, and clear cells were found in it. The clear cells form small collections but do not form expansile nodules. The final pathological diagnosis was multilocular cystic renal cell carcinoma. The follow-up was 20 months, without local re-currence or distant metastasis was found. Conclusions Multilocular cystic renal cell carcinoma (MCRCC) is a rare variant of renal cell carcinoma with a good prognosis. MCRCC is an uncommon tumor of the kidney composed of multiple cysts with clear cells in the septa indistinguishable from grade I renal cell carcinoma. Most patients are asymptomatie and the tumors are discovered inciden-tally. The preoperative diagnosis of MCRCC immediately depends on imaging studies. Pathology is the key to diagnosis.